从“有诸内者必形诸外”及体质论治小儿慢性荨麻疹  

Treating children chronic urticaria based on the theory of all inside surely form at outside and physique

作　　者：王丹[1] 侯江红[2] WANG Dan

机构地区：[1]河南中医药大学第二临床医学院,河南郑州450000 [2]河南省中医院,河南郑州450000

出　　处：《中医临床研究》2024年第17期129-133,共5页Clinical Journal Of Chinese Medicine

基　　金：2019年度河南省中医药科学研究专项课题(2019ZY2046)。

摘　　要：慢性荨麻疹因其反复发作、瘙痒难耐的特点严重影响患儿的身心健康,属于儿科临床难治病证。慢性荨麻疹虽属于外科范畴,侯江红教授认为“内之症或不及其外,外之症则必根于其内也”,治疗时不可拘泥于外治之法,必当思外而揣内,究其内在本因。考虑小儿好发该病,多责之于乳食所伤,侯教授指出小儿慢性荨麻疹的发生多由脾胃不和导致,因此临床辨证可从脾胃湿热型、气虚热盛型、营卫失和型入手,治疗采用培土生金法健运脾胃、调补肺脾、调和肺脾,以扶正固表、调和营卫、解表透疹。体质形成由脏腑盛衰偏颇所决定,因此亦认为体质因素是荨麻疹治疗与预防的重要病机,其中高敏偏颇体质患儿易出现荨麻疹、易咳嗽、哮喘等非健康倾向,故将调理高敏体质作为防治的重点,有效减少了患儿荨麻疹的复发率。此外还注重治养兼顾,讲求医患配合,从饮食、运动、作息、家长行为心理等方面改变养护观念,避免家长过度就医对患儿造成过度用药,通过非药物干预的方法来有效调动患儿自身免疫功能,亦增进了医患之间的信任。文章附案例一则,详细介绍侯江红教授治疗小儿慢性荨麻疹临证经验,以期为临床相关治疗提供参考。Chronic urticaria is a clinical refractory disease in pediatrics because of its characteristics of repeated attack and itching,which seriously affect the physical and menta health of children.Although the rash belongs to the category of surgery,Professor HOU Jianghong believes that the disease of the inside may have no external manifestations,but the disease of the outside must be rooted in the inside,the treatment should not be confined to the method of external treatment,must think outside and put inside,investigate its internal cause.The professor pointed out that the occurrence of chronic urticaria in children is mainly caused by the disharmony of the spleen and stomach.Therefore,clinical different of syndromes can be started from the three types of dampness-heat of the spleen and stomach,Qi(气)deficiency and heat excess,deficiency of Ying(营)and Wei(卫).The treatment adopts the method of soil cultivation and gold production,through the healthy operation of the spleen and stomach,regulating the lung and spleen,regulating the lung and spleen,in order to strengthen the solid surface,regulating Ying and Wei,relieving the surface and breaking the rash.The rise and fall of the Zang-Fu(脏腑)organs determines the difference in physical constitution.The hypersensitive and biased children show the unhealthy tendency of respecting urticaria,coughing easily,and asthma.Therefore,the recuperation of hypersensitive constitution as the focus of prevention and treatment can effectively reduce the recurrence rate of urticaria in children.In addition,it also pays attention to both treatment and maintenance,emphasizing doctor-patient cooperation,from diet,exercise,rest,parents’behavior psychology and other ways to change the maintenance concept,to avoid parents’excessive medical treatment of children caused by excessive drug use,through non-drug intervention methods to effectively mobilize children’s autoimmune function,but also enhance doctor-patient trust.This article is attached with one case to introduce the clin

关 键 词：小儿慢性荨麻疹 脾胃 肺脾 体质 

分 类 号：R758.24[医药卫生—皮肤病学与性病学]